Effects of psychosocial risk factors and prenatal interventions on birth weight: Evidence from New Jersey's HealthStart Program

Nancy E. Reichman, Julien O. Teitler

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


CONTEXT: Many states developed and implemented multifaceted Medicaid prenatal care programs in the late 1980s in response to expansions in Medicaid eligibility. Although these new programs were based on the presumed relationships between psychosocial risk factors, early prenatal care, prenatal interventions and birth outcomes, research has not verified all of these linkages. METHODS: Data were collected on 90,117 women who took part in New Jersey's comprehensive prenatal care program, Health-Start, between 1988 and 1996. The impact of psychosocial risk factors and prenatal interventions on mean birth weight and the odds of low birth weight (less than 2,500 g) was assessed using ordinary least-squares regression and logistic regression, respectively. RESULTS: After controls were introduced for social and demographic, psychosocial and behavioral factors, as well as the woman's county of residence and the year of her baby's birth, smoking drinking and using hard drugs (but not marijuana) during pregnancy were independently associated with reductions in mean birth weight (of 123 g, 29 g and 137 g, respectively) and with increases in the odds of low birth weight (odds ratios, 1.4, 1.2 and 1.7, respectively). However, according to the fully adjusted model, which also controlled for medical risk factors and prenatal services, the interventions designed to reduce those behaviors had no favorable effects on birth weight. In contrast, the receipt of services in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) was associated with an increase in mean birth weight of 22 g (and of 48 g among inadequately nourished women only), and with a reduction in the risk of low birth weight (odds ratio, 0.87). CONCLUSION: Referrals to WIC services should be a key feature of prenatal care programs for poor women.

Original languageEnglish (US)
Pages (from-to)130-137
Number of pages8
JournalPerspectives on Sexual and Reproductive Health
Issue number3
StatePublished - Jan 1 2003
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Sociology and Political Science
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

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